University of California, San Francisco study identifies most common reasons for children’s mental health hospitalizations

23 Mar

Moi wrote about troubled children in Schools have to deal with depressed and troubled children: Both the culture and the economy are experiencing turmoil. For some communities, the unsettled environment is a new phenomenon, for other communities, children have been stressed for generations. According to the article, Understanding Depression which was posted at the Kids Health site:

Depression is the most common mental health problem in the United States. Each year it affects 17 million people of all age groups, races, and economic backgrounds.
As many as 1 in every 33 children may have depression; in teens, that number may be as high as 1 in 8.
Schools are developing strategies to deal with troubled kids…. http://kidshealth.org/parent/emotions/feelings/understanding_depression.html

One strategy in helping children to succeed is to recognize and treat depression.

How Common Is Depression In Children?

According to Mary H. Sarafolean, PhD in the article, Depression In School Age Children and Adolescents

In general, depression affects a person’s physical, cognitive, emotional/affective, and motivational well-being, no matter their age. For example, a child with depression between the ages of 6 and 12 may exhibit fatigue, difficulty with schoolwork, apathy and/or a lack of motivation. An adolescent or teen may be oversleeping, socially isolated, acting out in self-destructive ways and/or have a sense of hopelessness.
Prevalence and Risk Factors
While only 2 percent of pre-teen school-age children and 3-5 percent of teenagers have clinical depression, it is the most common diagnosis of children in a clinical setting (40-50 percent of diagnoses). The lifetime risk of depression in females is 10-25 percent and in males, 5-12 percent. Children and teens who are considered at high risk for depression disorders include:
* children referred to a mental health provider for school problems
* children with medical problems
* gay and lesbian adolescents
* rural vs. urban adolescents
* incarcerated adolescents
* pregnant adolescents
* children with a family history of depression http://www.healthyplace.com/depression/children/recognizing-symptoms-of-depression-in-teens-and-children/

If you or your child has one or more of the risk factors and your child is exhibiting symptoms of prolonged sadness, it might be wise to have your child evaluated for depression.

How to Recognize Depression In Your Child?

MedNet has an excellent article about Depression In Children and how to recognize signs of depression in your child.
Signs and symptoms of depression in children include:

* Irritability or anger
* Continuous feelings of sadness, hopelessness
* Social withdrawal
* Increased sensitivity to rejection
* Changes in appetite — either increased or decreased
* Changes in sleep — sleeplessness or excessive sleep
* Vocal outbursts or crying
* Difficulty concentrating
* Fatigue and low energy
* Physical complaints (such as stomachaches, headaches) that do not respond to
treatment
* Reduced ability to function during events and activities at home or with friends, in school, extracurricular activities, and in other hobbies or interests
* Feelings of worthlessness or guilt
* Impaired thinking or concentration
* Thoughts of death or suicide
Not all children have all of these symptoms. In fact, most will display different symptoms at different times and in different settings. Although some children may continue to function reasonably well in structured environments, most kids with significant depression will suffer a noticeable change in social activities, loss of interest in school and poor academic performance, or a change in appearance. Children may also begin using drugs or alcohol,
especially if they are over the age of 12. http://www.onhealth.com/depression_in_children/article.htm

The best defense for parents is a good awareness of what is going on with their child. As a parent you need to know what is going on in your child’s world. https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Science Daily reported in the article, Study identifies most common, costly reasons for mental health hospitalizations for kids:

Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 14 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases — Kids’ Inpatient Database and Pediatric Health Information System — the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals…. http://www.sciencedaily.com/releases/2014/03/140317084531.htm

Citation:

Study identifies most common, costly reasons for mental health hospitalization

Date: March 17, 2014

Source: University of California, San Francisco

Summary:
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis. The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
Journal Reference:
1.Naomi S. Bardach, Tumaini R. Coker, Bonnie T. Zima, J. Michael Murphy, Penelope Knapp, Laura P. Richardson, Glenace Edwall, and Rita Mangione-Smith. Common and Costly Hospitalizations for Pediatric Mental Health Disorders. Pediatrics, March 2014 DOI: 10.1542/peds.2013-3165

Here is the press release from the University of San Francisco:

Study Identifies Most Common, Costly Reasons for Mental Health Hospitalizations for Kids
By Juliana Bunim on March 13, 2014
Nearly one in 10 hospitalized children have a primary diagnosis of a mental health condition, and depression alone accounts for $1.33 billion in hospital charges annually, according to a new analysis led by UCSF Benioff Children’s Hospital.
The study is the first to examine frequency and costs associated with specific inpatient mental health diagnoses for children, and is a step towards creating meaningful measures of the quality of pediatric hospital care.
“This is the first paper to give a clear picture of the mental health reasons kids are admitted to hospitals nationally,” said Naomi Bardach, MD, an assistant professor of pediatrics at UCSF Benioff Children’s Hospital and lead author. “Mental health hospitalizations have been increasing in kids, up 24% from 2007-2010. Mental health is a priority topic for national quality measures, which are intended to help improve care for all kids.”
The study will be published in the April issue of the journal Pediatrics.
More than 4 million children and adolescents in the United States have a diagnosable mental health disorder, yet little is known about which specific mental health diagnoses are causing children to be hospitalized. In the study, researchers found that depression, bipolar disorder and psychosis are the most common and expensive primary diagnoses for pediatric admissions.
“We now know through our analysis of cost and frequency which diagnoses are the most relevant,” said Bardach. “Next, we need to define what the optimal care is for children with these conditions so that hospitals can consistently deliver the best care for every child, every time.”
Using two national databases – Kids’ Inpatient Database and Pediatric Health Information System – the researchers looked at all hospital discharges in 2009 for patients aged three to 20 years old to determine the frequency of hospitalizations for primary mental health diagnoses. They compared the mental health hospitalizations between free-standing children’s hospitals and hospitals that treat both adults and children, to assess if there was a difference in frequency of diagnoses.
The study found that hospitalizations for children with primary mental health diagnoses were more than three times more frequent at general hospitals than free standing children’s hospitals, which the researchers say could indicate that general hospitals have a greater capacity to deliver inpatient psychiatric care than free-standing children’s hospitals.
At both kinds of hospitals, the most common mental health diagnoses were similar (depression, bipolar disorder, and psychosis), which the researchers say supports the creation of diagnosis-specific quality measures for all hospitals that admit children.
Depression accounted for 44.1 percent of all pediatric primary mental health admissions, with charges of $1.33 billion dollars, based on the billing databases used in the study. Bipolar was the second most common diagnosis accounting for 18.1 percent and $702 million, followed by psychosis at 12.1 percent and $540 million.
“These are costly hospitalizations, and being hospitalized is a heavy burden for families and patients. Prevention and wellness is a huge part of the Affordable Care Act, along with controlling costs by delivering great care,” said Bardach. “This study helps us understand that mental health is a key priority. The long term goal is not only to improve hospital care for these kids, but also to understand how to effectively optimize mental health resources in the outpatient world.”
Co-authors include Tumaini Coker, MD, MBA and Bonnie Zima, MD, MPH, both of UCLA; J. Michael Murphy, EdD, Massachusetts General Hospital Boston; Penelope Knapp, MD, UC Davis; Laura Richardson, MD, MPH and Rita Mangione-Smith, MD, MPH, both of the University of Washington School of Medicine, Seattle; and Glenace Edwall, PsyD, PhD, MPP, Minnesota State Health Access Data Assistance Center.
The study was supported by the Agency for Healthcare Research and Quality and the National Institute for Children’s Health and Human Development.
UCSF Benioff Children’s Hospital creates an environment where children and their families find compassionate care at the forefront of scientific discovery, with more than 150 experts in 50 medical specialties serving patients throughout Northern California and beyond. The hospital admits about 5,000 children each year, including 2,000 babies born in the hospital.

If you or your child needs help for depression or another illness, then go to a reputable medical provider. There is nothing wrong with taking the steps necessary to get well.

Related:

GAO report: Children’s mental health services are lacking
https://drwilda.com/2013/01/12/gao-report-childrens-mental-health-services-are-lacking/

Schools have to deal with depressed and troubled children:
https://drwilda.com/2011/11/15/schools-have-to-deal-with-depressed-and-troubled-children/

Where information leads to Hope. © Dr. Wilda.com

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